The training of physician-scientists capable of conducting innovative research of musculoskeletal diseases constitutes an important component of the nation's biomedical research agenda. Historically, physician-scientists have made seminal contributions to understanding the biological basis of health and disease. However, the supply of bright, young scientists capable of continuing these achievements is threatened. Over the past decade, the number of newly trained physicians pursuing academic medicine has dwindled. The cause of this downward trend is multifactorial. One important explanation for this problem may be related to a lack of positive role models for young physicians. Consequently, few take an interest in academic medicine as a future career. It is therefore critical to support programs that are committed to attracting and training young physicians interested in academic medicine. The UCSD Orthopaedic Research Training Program is well suited to meet this challenge. The UCSD program has been the recipient of the NIH Training Grant for past 20 consecutive years. It is one of the only orthopedic residency programs that offers dedicated time for full-time basic science research in addition to a full clinical orthopedic training program. It continues to attract bright young physicians from around the country through its reputation in both its research and clinical excellence. The program faculty is comprised of over 15 orthopedic surgeons and 7 full time basic scientists. There is a balance of highly successful senior faculty and young, energetic junior faculty. There are well-established core research laboratories. While each core lab pursues distinct research programs, there is an unusually high degree of collaboration between the various core labs and between the core labs and the clinical faculty. The core labs and faculty study a wide array of orthopedic diseases. These include diseases of particular cartilage (cellular apoptosis of chondrocytes, cartilage repair, and cartilage transplantation), connective tissues (ligament healing, epidural scar formation), muscle physiology (compartment syndrome, muscle adaptation after tendon transfers), and neurophysiology/spine (biology of spine fusion, chronic pain), and bone biology (fracture healing, osteoporosis). Formal course work is required in statistical analysis, experimental design, project development, scientific integrity, and biomedical ethics. Scheduled conferences include weekly Orthopaedic Research Conference, Grand Rounds, Anatomy Dissection, and Journal Clubs. In the past 20 years, this program has produced physician-scientists who have presented research at numerous national meetings and published in peer-reviewed journals. A large number go on to academic careers. The ongoing;long-term objective of the UCSD Orthopaedic Research Training Program is to produce a core group of physician scientists capable of conducting innovative, multidisciplinary research in the musculoskeletal sciences.